Every day, 20 people take their lives in Nepal. We are among the countries with the highest suicide rates and consistently fall in the WHO’s Top 10 list. This figure is alarming, especially for a country with only 30 million people. Reducing one-third of premature deaths from non-communicable diseases is a target Nepal has pledged to achieve under the Sustainable Development Goals (SDGs). Although the government aims to cut the suicide rate to 4.7 per 100,000 people by 2030, the suicide rates are only increasing by the year.

In the fiscal year 2023-2024, Nepal recorded the highest number of suicides to date, with 7,223 individuals reported to have taken their lives, according to the Nepal Police. What’s troubling is that these figures may not reflect the true scale of the problem, as the country lacks consistent national data on suicide, which results in a significant underreporting of suicide attempts. Due to the lack of a hospital-based suicide registry, we have no option but to rely on police data, which fails to provide details of suicide and excludes unsuccessful suicide attempts. This is why the recent initiative from the Ministry of Health and Population to introduce a hospital-based suicide registry at Ilam Hospital in the Koshi Province and Mahakali Provincial Hospital in the Sudurpaschim Province is encouraging.

The answer to addressing suicide and mental health issues among people isn’t straightforward. There is a complex interplay of factors that push individuals to take their own lives. Ours is a society that doesn’t prioritise mental health problems and help-seeking behaviour. Further, people usually ignore mental health issues while talking about suicide. Increasing unemployment, exploitation in the job environment, rising prices, loneliness, and societal pressures have only made things worse. So it is vital that we understand suicide beyond the numbers to know who is most at risk, why and when they are driven to take their lives and how we can address the issue.

Before the onset of the pandemic, a study by the Nepal Health Research Council revealed that over 10 percent of the adult population had experienced mental health issues at some point in their lives. The situation worsened when Covid-19 brought with it financial setbacks, rising domestic violence and more. This prompted a growing discourse on people’s mental well-being on social media. The situation presented a timely chance for the authorities to commit to people’s mental wellness. Although it has been two years since the pandemic’s end, the agencies under the ministry do not even have the funds to provide something as basic as mental health screening training to children and adolescents.

It is essential to recognise that mental health issues are closely linked to broader socio-economic problems and require collaboration of various stakeholders and agencies. Countries like Bhutan and India have already launched their national suicide prevention action plans, but Nepal continues to lag behind. Although the National Planning Commission had planned to release Nepal’s action plan in 2024, it is still under development.

Further, even as the establishment of a suicide registry in the two hospitals is commendable, such localised efforts aren’t enough for large-scale systemic data collection to better understand suicide trends. We must stop dillydallying and expedite the establishment of nationwide hospital-based suicide registries. As important is fostering an environment where people’s mental health is valued. Delaying action on suicide prevention until we see another record-breaking number of deaths is simply unacceptable.

If you or someone you know is considering suicide, please contact the following helplines.

Nepal Mental Hospital suicide hotline: 1166

Tribhuvan University Teaching Hospital suicide prevention hotline: 9840021600

Patan Hospital crisis helpline for suicide prevention: 9813476123

The Transcultural Psychosocial Organisation: 16600102005